Tag Archives: Population health

I just got back from a jam-packed few days in Vegas for HIMSS 2016. Just me and 40,000 of my closest HIT friends.

The mix was 2/3 vendors, 1/3 healthcare systems, I heard. Lots of excitement, lots of energy, lots of promise. Lots of walking.

As I step back, I see four main themes jump out: Interoperability, population health, telehealth, patient engagement. Here’s my quick take on each.

Interoperability: Getting devices to talk to each other, share data, and play nicely together for the higher good- better care, better outcomes. Along with improving mediating outcomes like workflow and reducing errors. Kudos to device and IT companies for sharing and letting go of turf. It’s certainly time.

Population health: All about prediction to figure out whom to provide what services to. Seems to be a modern version of managed care in terms of bottom line purpose, but driven by predictive analytics and with far more tailoring of care. The key piece still under-estimated is how hard it can be to get people to change health behaviors.

Telehealth: Keeps evolving to let more and more care and monitoring happen remotely (or “out-of-person” vs. “in-person”). Now it’s not just connecting provider and patient, it covers connecting providers and providers, providers, payers, and patients, etc. This will challenge our paradigm about what monitoring, diagnosing, and treating can only be done in-person. I think the litmus test for clinical care is empathy – to what extent can a provider truly empathize and thereby deeply understand a patient through mediating technology.

Patient engagement: Though it’s been around since the earliest days of healthcare, it now means all kinds of things and is catalyzing a wide variety of new products and services. Key issues here are about defining what it is and isn’t, developing objective metrics, and making it not a separate “thing,” but an integral and unavoidable part of every healthcare interaction.

Better interoperability behind the scenes, plus telehealth to enhance and extend relationships, combined with population health to focus resources, improves patient engagement to make it all matter.

A key promise of the population health phenomenon, so important to payors, providers, and suppliers is this: We need the public to get healthier. That requires participation. If payors pay, people will take advantage of free preventive services to get healthy.

Here’s how the Kaiser Family Foundation put it in their recent Health Reform overview (see bold): A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing. Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions, and that some services are also cost-effective. However, costs do prevent some individuals from obtaining preventive services. The coverage requirement aims to remove cost barriers.

The reality is that while cost is a barrier for some people, it’s not the only barrier. It may not even be the main barrier. Now you might be thinking, if preventive services have been proven to improve health and save lives, why would people NOT make use of them, especially when they’re free? What other barriers might there be?

In my two decades of experience working with CDC, CMS, FDA, and many public health efforts, behavior change is the holy grail. And maybe the hardest to achieve. The main barrier I believe is not money, but motivation. People will find all kinds of reasons (beyond costs) to NOT sign up for free preventive services, including: 1) I’m not sick, 2) I don’t need whatever those services are, 3) I’ll do it later.

Prevention has alway been a tough sell. The fundamental benefit promised is that something bad (illness) will not happen down the road. Many people don’t see that as compelling or personal relevant in a life with so many demands in the here and now.

The solution requires: 1) increasing immediate personal relevance, 2) making it simple to do. As my friend and colleague Peter Mitchell, head of Salter Mitchell’s MarketingForChange practice, says, make it fun, easy, and popular. Building on that, I like the FEFE acronym- Fun, Easy, Fast, Effective.

Research trends in the science of persuasion, behavioral economics and decision-making, social psychology, and marketing science, provide convergent evidence that motivating health behavior change and utilization of preventive services is no simple task, and requires far more than data, information, and logic.

Bottom line, population health players need to employ multiple approaches to motivate behavior change, and to not assume that a logical (and free) offer will do the job.

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FYI, here are a few more resources on motivating health behavior change: